Wednesday, December 07, 2011

Know Your Heart Condition And Sports

Another life was lost last weekend during the SCMS 2011 run. A young 22 years old man by the name of Malcolm Sng (RIP) was known to be a fit person that earned the nickname "Man Of Steel" from those that know him. He was one of the fitter ones in his Basic Military Training (BMT), according to those that know him during his National Service days. He ran the 21km race in 1:53 - collapsed upon crossing the line and pronounced dead at 9.30am - an hour after he collapsed. His last run before this was in September 2011.
If all of you remember, there was another death in our country Malaysia during the SCKLM run in 2010 where a 10km participant collapsed with about 2km to go. Runners that saw that rushed to his aid and some even performed CPR on him. Sadly, medical was insufficiently equipped (no AED or defibrillator) and many would remember the inaction by authority that could had used his radio to call for ambulance.
Some would say that Singapore is so perfect - since the organizers was not apprehended on social media unlike what happened in KL. Lets look at the two incident objectively. Both has a young man passing on while running. Both started racing recently (before the incident) and both are at the best of their health, fitness wise. While one received immediate medical attention upon collapsing the end results for both were the same - they could never come back again.
While the investigation is underway for Malcolm, the condition that caused the Malaysian boy to pass on was attributed to under laying heart condition.
In fact, he was not the first one. Remember the other race in Shah Alam where another young man collapsed and died while walking to his car?
Or the national junior badminton player that suffered the same fate after his training just recently?
Closer to home, i lost two friends; one an online friend i never met physically and the other, Kharis or TSB recently - both due to heart condition.
Here are the coincidental cause - cardiovascular or heart failure.
One of the most common cause is abnormal heart rhythm or arrhythmia. Lets look at what this foreign sounding medical terms (as with all medical terms too) is.
Arrhythmia is best described as irregular heartbeat. It has nothing to do with you getting excited when you see someone you love (aka skipping a heartbeat). It can occurs even with someone that has regular heartbeat (50-100bpm), low heartbeat (less than 50) or high heartbeat (more than 100). It can cause by a few factors such as:
1. electrolyte imbalance mostly due to natrium(sodium) - kalium (potassium) imbalance.
2. injury from heart attack or recovery from heart surgery, of which either one would contribute to changes in the heart muscle function/memory
3. Irregular heart rhythm which include other medical condition such as heart flutter, abnormal contraction of artery and/or ventricle.
As you can see, many of us that does the sports (swim and/or bike and/or run) are relatively "fit". Many of us are not aware of under laying condition of our own health, despite getting health screening perhaps only when the job job requires us to. Many a time, we would not be able to recognise the tell-tale sign, but the typical symptoms are:
1. palpitation of the heart (where you feel your heart skipping a beat or suddenly felt like it is drumming away)
2. Pain or tightness in the chest (oh-uh...)
3. Feeling light headed or dizziness
4. short of breath
5. feeling tired even though just doing menial task.
I have experienced up to all five of the above at any one time. Sometimes, we thought we are having low blood pressure or low iron level, but in actual fact, the cause could be more severe. Those that often misses out on their sleep and worked through the night will experience palpitation and feel lightheaded. Reason why rest is crucial for athletes as much as it to train.
So, the next question would be how one could actually strike out all possibilities and actually know what is causing the symptoms above? A comprehensive medical examination that includes ECG or electrocardiogram test, or a stress test (running on treadmill with HR and blood pressure monitored) could be an inexpensive way to prediagnose this condition.
Arrhythmia condition could be treated via drug usage, usually to thin the blood (such as aspirin) to prevent possibility of stroke due to blood clot. If the condition could not be treated by drugs, it will usually requires a  lifestyle change.
We human are habitual beings, lifestyle change will be difficult to some and often it requires discipline and life-changing decision. Some of the suggested changes that should be incorporated includes quitting smoking,  limits the consumption of alcohol and caffeine (including soft drinks) and perhaps even a diet revamp for a more holistic cardiovascular health including the health of the arteries and lipid (fat) profile. One of the more difficult change would be to limit the activities that causes the condition, especially if it involves the activities we love such as the swimming, cycling and running. The key to this would be a very conscious effort to STOP if we have fainting spell or tightness or pain in the chest. That would be the first indication.
Arrhythmia could lead to more deadly repercussion if not recognised such as heart attack.
Putting all the equations above, i could very generally equate the recent death of some of our fellow friends to possible over training with imbalance diet (electrolyte imbalance - could meant under or over dosing) while pushing very hard to accomplish to obtain a personal best timing possibly with inadequate rest due to anxiety before race days or running up to race day.
I am not a doctor, but my common sense tells me that the sign is always there and it is ourselves that choose to ignore them.
I often race with a heart rate monitor (HRM) so i could monitor my own condition if i am pushing myself too hard or within my own limits. I even stopped running once when i felt immense tightness on my chest just after 2km of running at an easy pace. It is never nice to just "drop dead" - life is too short to let it end that way.
Stay conscious, stay informed and stay alive. There will always be another race for another day.


  1. thanks bro.. this is really2 help..

    i am getting this last 2 month (after checkup and confirm by hospital).. i blve due to over workout which having a lot of event in a month + high colestrol at that time..

    Anyway.. by knowing the limit is the best method.. listen to your body..

  2. we know our body best, but most novice overestimated their abilities, with sufficient training and listening to our bodies, we should be fine

  3. Arman - hope you are fine. Keep up our boring hamster diet and we be cholesteol problem free :)

    Anon - sometimes, in the haste to get that 1minute PB, we choose to ignore tell tale sign. How many time we pull back when something not quite right happened?

  4. Thanks for the great article/info,bro stupe..
    my dad collapsed at finishing line during 2010 SCKLM 21km..and that was after conquering Mount Kinabalu a week before the race..doc diagnosed n concluded that its arrhythmia..he used to run 42k sub 4.30 back in old days..
    thank god that its not serious but had to stay at GH for few days..
    point is..we need to listen to our body..but some time in marathon..we tend to do/outdo our PB ignoring our body..

  5. Bro Gold - sorry to hear about your dad. I wish him well and for a complete recovery.

    You are right, many times, we forgo that warning just for that 1min PB. It's not worth it...

  6. Thanks for the article bro.. It's true, listen to our body and do not push beyond what our body's limit is.. Not everyone is build alike ! 2 weeks ago, there were also 2 deaths at Philadelphia Marathon and spawned many discussion about this.. Like to share the 2 articles here as well.
    Run strong but more importantly, Run Safely !

  7. Don't forget, doping is one of the main reason for sudden cardiac death esp among amateur athlete. But not pro,since they can easily get cought and banned.

  8. Anon - perhaps that too. When the only things that matter is winning, death comes second.

    However, the recent death of runners could very well because of other factors. I am doing a research on it now as some evidence points to over hydration as the cause. Wait up for that posting.

  9. Thanks for this reminder. Need to get myself checked too. I've experienced those symptoms you've mentioned at times. But its easy for people like us to ignore...

    Read this:…-industry-icon-in-the-fight-of-his-life/

    This world class athlete reminds us how to never take our fitness levels for granted.

  10. right on Noel. Most "fit" people will take these for granted as they will think what are the chances it will hit them.

    Unlike professional athletes with personal team doctors and even dietician at their perusal, the average joes and janes out there (like me and wifey) must be extra careful. Most of the time, it is not worth that "better" 2 minutes we will achieve if we push hard enough.

    train well, eat well, rest well, stay alive well alive.